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Heart Failure and the Echocardiogram

An echocardiogram (often called an "echo") is a graphic outline of the heart's movement. During this test, high-frequency sound waves, called ultrasound, provide pictures of the heart's valves and chambers. This allows the technician, called a sonographer, to evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

Why Do I Need an Echocardiogram?

Your doctor may perform an echo to:

  • Assess the overall function of your heart.
  • Determine the presence of many types of heart disease, including heart failure.
  • Follow the progress of heart valve disease over time.
  • Evaluate the effectiveness of medical or surgical treatments performed on the heart.

What Are the Types of Echocardiograms?

The types of echos include:

  • Transthoracic echocardiogram. This is the standard echo. It is a painless test similar to X-ray, but without the radiation. The procedure uses the same technology used to evaluate a baby's health before birth. High frequency sound waves (ultrasound) are bounced off the heart structures (using a device called a transducer) producing images and sounds that can be used by the doctor to detect heart damage and disease.
  • Transesophageal echocardiogram (TEE). This test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach.) Because the esophagus is located close to the heart, clear images of the heart structures can be obtained without the interference of the lungs and chest.
  • Stress echocardiogram. This is an echo that is performed while the person exercises on a treadmill or stationary bicycle. This test can accurately visualize the motion of the hearts walls and pumping action when the heart is stressed; it may reveal a lack of blood flow that isn't always apparent on other heart tests. The echo is performed just prior and just after the exercise.
  • Dobutamine or adenosine stress echocardiogram. This is another form of stress echo. However, instead of exercising to stress the heart, the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. The test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. The test is also used to determine how well your heart tolerates activity, determine your likelihood of having coronary artery disease (blocked heart arteries) and evaluate the effectiveness of your cardiac treatment plan.
  • Intravascular ultrasound. This is a form of echocardiography performed during cardiac catheterization (a procedure done to visualize the heart arteries). During this procedure, the transducer is threaded into the heart blood vessels via a catheter in the groin. It is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

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